Monday, March 01, 2021

Preparing for the Unthinkable, Part 2 - Trauma Kits

Let's Talk Trauma Kits

Shira and I recently attended Until Help Arrives (UHA) training, a County designed class to train bystanders to save lives during a mass casualty event. In the class, they highlighted a number of store-bought materials minimally trained individuals can use to save lives. I've compiled these items to form two different types of trauma kits.

The first kit is a full sized, deluxe version. It's bulky, but contains everything a person needs to execute the TECC Active Bystander Guidelines. It's intended to be staged near a potential catastrophe: say, in a desk drawer, behind a bimah, or in the trunk of a car.

The pocket version is more compact, but requires that you augment it with materials in the field. It's intended to go in your purse, or man bag. It gets deployed when a crisis happens at an unexpected location, like a concert or a movie theater.

Before I dive into the details of each kit, let's talk about a favorite topic: improvisation.

On Improvisation

Whenever the topic of trauma kits comes up, there's typically mention of two principles: first, that the items found in a trauma kit can be improvised from everyday materials. If you have a table cloth, fork and steak knife, then you can craft a tourniquet with relative ease. The second principle: for a minimally trained individual, purpose-built devices are going to be far more successful then their improvised cousins. So, yes you can make a tourniquet out of a table cloth, but in a high-stress situation where a loved one has minutes to live, you're going to be far more successful with a SAM XT tourniquet than the home made version.

I would  add to that discussion that there's broadly two flavors of improvisation: planned and unplanned. One common improvisation is to create a chest seal out of a Ziploc bag and tape. Consider Alice who happens to keep a Ziploc bag and tape in her purse. Both these items are nearly weightless, bulk-less and have countless uses. If an emergency happens, Alice can improvise a chest seal out of items she knows she has on her person. Bob, on the other hand, hasn't staged these items. If an emergency happens, he needs to first search out a baggie and tape before he can start improvising. The best option is for both Alice and Bob to have access to a stocked trauma kit which would contain a medical grade chest seal. If that's not possible, I'd argue that Alice is in a far better position than Bob to deliver care even though they are both improvising.

My point: if you have to fallback on improvisation, a little planning can go a long way.

The Full Size Kit

Primary Tourniquet: SAM XT - this is the UHA's recommended tourniquet and I see why. Its satisfying click when you tighten it in place helps assure you  that you're using it properly. In the situation above where a loved one is bleeding uncontrollably, this is the device you want on hand.

Secondary Tourniquet: SWAT-T Tourniquet. Not as easy to deploy as the SAM-XT, but still a reputable, field proven tourniquet. It has the advantage of being multi-purpose and working on limbs of any size, including children and pets.

Pressure Dressing: 6" Israeli Bandage. The Israeli Bandage is a legendary piece of battlefield kit. Instead of having to carefully dress a wound with a gauze pads and then wrap it with an Ace-wrap to keep it in place, the Israeli Bandage provides an all in one solution. For bleeding that doesn't call for a tourniquet the Israeli Bandage is the way to go.

Secondary Pressure Dressing: SWAT-T Tourniquet + Gauze.

Wound Packing Aid: Rolled Gauze. This may get swapped out with hemostatic gauze at some point, but for now, cheap, multi-purpose gauze is the winner.

Chest Seal: HyFin Vent Chest Seal. Bulky and relatively expensive these do one job, and do it well. If you ever need to do deploy a chest seal, you're going to be glad you didn't skimp.

Hypothermia/Shock Treatment: S.O.L. Heatsheet Emergency Blanket. In theory, a cheap (around $1.00) Mylar blanket will keep a victim warm while you take other actions to raise their body temperature. However, I like to splurge on the upgraded Heatsheet version because they are less likely to tear, are quieter to use and I've got a track record of using them successfully in the woods.

Other Tools: Medical Scissors and Nitrile Gloves. The scissors are helpful in exposing wounds. The gloves are standard PPE.

The Pocket Version

Primary Tourniquet: SWAT-T. Given the size restrictions of the pocket kit, the SWAT-T is the way to go.

Primary Pressure Bandage: SWAT-T + any fabric you have on hand. The fabric can be almost anything: a handkerchief, COVID mask, part of your clothing, etc.

Wound Packing Aid: Any fabric you have on hand. This may be on your person, a handkerchief, Buff, t-shirt, etc. Or, this may be in your environment: a sheet, towel, table cloth, curtains, etc.

Chest Seal: improvised from the bag that holds the kit, and the included tape.

Hypothermia/Shock Treatment: S.O.L. Heatsheet Emergency Blanket.

Other Tools: Leukotape and Nitrile Gloves. The Luekotape is a terrifically useful item to have and has far more uses than just creating a chest seal.

Pro Tip: All the items I purchased for the above kits were reimbursed when Shira submitted a Flex Spending Account (FSA) claim. She classified both styles of tourniquets, the chest seals and the the Israeli bandages under the section pertaining to bandages.  So if you find yourself with extra FSA bucks at the end of the year, it's a safe bet to put some of that money towards emergency medical supplies.

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